Large gaps worldwide in prophylactic treatment of migraine

The CaMEO-International (CaMEO-I) study investigated self-reported use of preventive migraine medication and the need for preventive medication. Over three-quarters of people with migraine who qualify for preventive treatment do not receive it. Moreover, about half of patients who do receive preventive medication do not experience adequate benefits from their current medication.

CaMEO-I is a cross-sectional, observational, web-based survey conducted in 2021–2022 in Europe, North America, and Japan. CaMEO-I is a follow-up study of CaMEO (Chronic Migraine Epidemiology and Outcomes), which had a similar design and was conducted in 2012–2013. The results back then showed that preventive migraine treatment was only used by a minority of US patients eligible for such treatment. New treatment options have emerged since, and new consensus statements have been issued [1,2].

CaMEO-I included 14,492 respondents who met the modified International Classification of Headache Disorders, 3rd edition (mICHD-3) criteria for migraine [3]. Of these, 31.5–42.1% qualified for prophylactic treatment based on the American Headache Society (AHS) Consensus Statement. However, preventive use among respondents who qualified for preventive treatment, the percentage actually on preventive treatment ranged from 10.1% in Japan to 17.5% in the UK, and 22.4% in the US. Thus, most people with migraine who qualified for prophylactic treatment were not receiving it.

CaMEO-I further revealed that, in each of the participating countries, the use of an oral prophylactic therapy was reported at least 3 times more often than the use of an injectable therapy. Also, among current users of prophylactic medication, 41.1–59.1% still met the AHS criteria for preventive treatment, suggesting that their medication is not sufficiently effective.

The authors stated that education on available preventive treatments, as well as assistance with access, may help address the current barriers to treatment.

1. 1. Ailani J, et al. Headache. 2021 Jul;61(7):1021–39.
   2. Ailani J, et al. Headache. 2021 Jul;61(7):1021–39.
   3. Buse DC, et al. Characterizing gaps in preventive treatment of migraine: global results from the CaMEO-International study. Poster P124, EHC 2022, 07–10 December, Vienna, Austria.

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